scholarly journals Indications for hemithyroidectomy for nodular goiteragainst the background of autoimmune thyroiditis and prognosis of long-term results

2021 ◽  
pp. 14-20
Author(s):  
А. V. Shidlovskyi ◽  
V. А. Shidlovskyi ◽  
M. I. Sheremet ◽  
A. V. Lazaruk ◽  
O. H. Netsiuk ◽  
...  
Keyword(s):  
Thyroid Gland ◽  
Satisfactory Result ◽  
Autoimmune Thyroiditis ◽  
Structural Changes ◽  
Free Thyroxine ◽  
Long Term Results ◽  
Blood Levels ◽  
Thyroid Peroxidase ◽  
Compression Syndrome

Aim — to study the possibility of determining the indications for choice of the extent of surgery in patients with unilateral nodular goiteragainst the background of autoimmune thyroiditis(AIT) with compression syndrome and prognosis for the long-term results of surgical treatment.Materials and methods. The analysis has been performed for the long-term results of hemithyroidectomy in 101 women aged from 23 to 72, patients with unilateral nodular goiteragainst the AITbackground with compression syndrome. It has been established what exactly indications to the surgery,includingvolume of the gland, echostructure variant, blood levels of thyroid stimulating hormone(TSH), free thyroxine and triiodothyronine, thyroid peroxidase(TPO) antibodies, apoptosis and proliferation indicators, provided satisfactory and unsatisfactory treatment results.Results. Based on the results of investigation in 3 years after hemithyroidectomy, no violations of the functional state of the thyroid glandwere revealed in 75 patients; in them ultrasoundinvestigation of parenchyma of the remaining lobe of the gland showed that pre-operativeAITsigns did not progress or progressed without hypothyroidism and changes of the variant of ultrasound picture (satisfactory result). In 26 patients an increase in the volume of the remaining part of the thyroid gland and progression of the autoimmune process with the development of hypothyroidism were established (unsatisfactory result).One can expect the satisfactory result of hemithyroidectomy in the treatment of patients with unilateral nodular goiteragainst the AIT backgroundwith compression syndrome in cases where at the time of surgery the volume of the lobe does not exceed 10 cm3, its echostructure corresponds to hypoechoic and heterogeneous and pseudomicronodular variants, TSH is not higher than 2.85 IU/L, levels of free thyroxine and triiodothyronine are not lower than 16.7 and 5.3 pmol/l, respectively, TPO antibodies level is not higher than 150 IU/ml.Conclusions. One of the possible options for surgical treatment of patients with unilateral nodular goiteragainst the AIT background with compression syndrome may be hemithyroidectomy with preserved hormonal function of the gland and structural changes in the parenchyma in the lobe, which remains at the level of hypoechoic and heterogeneous or pseudomicrous variants. Hemithyroidectomy is contraindicated in cases of pseudolarge nodular and severe variants of parenchyma echostructure of the thyroid gland.

scholarly journals Surgical treatment of unilateral nodular goiter with compression syndrome in patients with autoimmune thyroiditis

2021 ◽  
pp. 37-43
Author(s):  
O. V. Shidlovskyi ◽  
V. O. Shidlovskyi ◽  
M. I. Sheremet ◽  
O. V. Lazaruk ◽  
V. M. Pryvrotskyi ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Thyroid Gland ◽  
Nodular Goiter ◽  
Thyroid Stimulating Hormone ◽  
Long Term Results ◽  
Blood Levels ◽  
Thyroid Peroxidase ◽  
Compression Syndrome ◽  
Proliferation And Apoptosis

Aim — todetermine indications for the choice of the surgery scope in patients with unilateral nodular goiter with compression syndrome against the background of autoimmune thyroiditis (AIT) and possibility of prognosis of the long-term results of surgical treatment.Materials and methods. The analysis has been performed for the long-term results of hemithyroidectomy in 101 femalepatients aged 23 to 72 years with unilateral nodular goiter against the background of AIT (NGAIT) with compression syndrome. The pre-operational levels of the following parameters, definingsatisfactory and unsatisfactory treatment results, have been analyzed: volume of the lobe of the gland, blood levels of thyroid stimulating hormone, free thyroxine and triiodothyronine, antibodies to thyroid peroxidase, indices of apoptosisand proliferation, variants ofechostructure.Results. Satisfactory results have been established in 75 patients based on the following results of examinations 3 years after hemithyroidectomy: no violations of thyroid gland functional state, andno progression of preoperative AIT signs or progression without hypothyroidism and changesin ultrasound picture in the parenchymaof the remaining lobe of the gland according to the data of ultrasound investigation.Unsatisfactory results were definedin 26 subjects: an increase in the volume of the remaining thyroid gland and the progression of autoimmune process with the development of hypothyroidism. A satisfactory result of hemithyroidectomy in the treatment of patients with NGAIT with compression syndrome can be expected in cases where at the time of surgery the volume of the lobe was not more than 12.7 cm3, its echostructure corresponded to hypoechoic and heterogeneous and pseudomicronodular variants, and the following blood levels were established: thyroid stimulating hormone < 2.85 IU/L, free thyroxine > 16.7 pmol/l, free triiodothyronine > 5.3 pmol/l, antibodies to thyroid peroxidase < 137 IU/ml.Conclusions. One of the possible options for surgical treatment of patients with unilateral nodular goiter against the background of AIT with compression syndrome may be hemithyroidectomy in conditions of preserved hormonal function of the gland with moderately pronounced processes of proliferation and apoptosis, structural changes in the parenchyma at the level of hypoechoic and heterogeneous and pseudomicro-nodal echostructural variants. The use of hemithyroidectomy is contraindicatedin cases of pseudo-large-nodular and more severe variants of the echostructure of the thyroid parenchyma, regardless of the indicators of hormone-producing function, antibodies to thyroid peroxi­dase, proliferation and apoptosis.

Effects of Environmental Chemicals on the Course of Autoimmune Thyroiditis

2020 ◽  
pp. 18-23
Author(s):  
I.E. Shtina ◽  
M.T. Zenina ◽  
Yu.A. Ivashova ◽  
S.L. Valina ◽  
O.Yu. Ustinova
Keyword(s):  
Thyroid Gland ◽  
Autoimmune Thyroiditis ◽  
Structural Changes ◽  
Environmental Exposures ◽  
Incidence Rates ◽  
Thyroid Stimulating Hormone ◽  
Environmental Chemicals ◽  
Blood Levels ◽  
Observation Group ◽  
Industrial Chemicals

Introduction. The relevance of the research is attributed to the increased incidence of autoimmune thyroiditis in children, especially those dwelling in contaminated areas. Our objective was to study effects of environmental exposures to industrial chemicals on the course of autoimmune thyroiditis. Materials and methods. In order to establish the relationship between specific features of the course of autoimmune thyroiditis and adverse environmental exposures, we conducted a comparative study of incidence rates of thyroid diseases including thyroiditis, cytotoxicity testing, thyroid status assessment, antioxidant activity assays, and thyroid ultrasound. The observation group consisted of 98 children living the area with the developed metallurgical industry while the comparison group included 23 children living in a recreation area. The groups were matched by age and socio-economic characteristics. Results. We established that thyroiditis incidence rates in the industrially polluted area were almost thrice as high as those in the relatively clean area. The observation group was characterized by smoothed sexual differentiation, earlier development of the autoimmune thyroiditis, higher (up to 1.6 times) frequency of typical diffuse structural changes, and increased thyroid gland. Blood levels of metals having a direct cytotoxic effect on the thyroid gland were 2.0 to 6.7 times higher than normal in the cases compared to their matched controls. The correlation and regression analysis established contribution of chemicals to the increased incidence of autoimmune thyroiditis in children (zinc), antibodies to thyroid gland tissue (lead), thyroid-stimulating hormone (nickel), and decreased resistive indices (lead). Conclusion. High blood levels of lead, nickel and zinc were among the factors having an adverse effect on the course of AIT and thyroid function.

Hormonal contraception in women with diffuse nontoxic goiter and autoimmune thyroiditis

2013 ◽  
Vol 62 (5) ◽  
pp. 45-51
Author(s):  
Galina Petrovna Pologoyko
Keyword(s):  
Thyroid Gland ◽  
Oral Contraceptives ◽  
Autoimmune Thyroiditis ◽  
Reproductive Age ◽  
Control Group ◽  
Blood Levels ◽  
Thyroid Peroxidase ◽  
Combined Oral Contraceptives ◽  
Nontoxic Goiter ◽  
And Function

The article considers the influence of combined oral contraceptives on size and function of thyroid gland in women of reproductive age. We examined 215 women, taking low dose and microdose combined oral contraceptives for 12 months as monotherapy or in combination with potassium iodide. The first group consisted of 75 women with diffuse nontoxic goiter, second – of 70 women with autoimmune thyroiditis. Control group consisted of 70 women without pathology of thyroid gland. Prior to therapy with combined contraceptives and after 12 months of treatment, we determined serum levels of free triiodothyronine, free thyroxine, and thyrotropin releasing hormone, antibodies to thyroid peroxidase and antibodies to thyroglobulin (ELISA) and performed sonography of thyroid gland. Results of our study suggest that combined oral contraceptives may increase the size of thyroid gland among women with diffuse nontoxic goiter without changing its function. In women with autoimmune thyroiditis, application of combined oral contraceptive significantly decreases blood levels of autoantibodies to thyroid peroxidase and thyroglobulin. Application of combined oral contraceptives in healthy women doesn’t influence the size and function of thyroid gland.

A New Classification for Pathologies of Spinal Meninges, Part 1: Dural Cysts, Dissections, and Ectasias

Neurosurgery ◽  
2017 ◽  
Vol 81 (1) ◽  
pp. 29-44 ◽  
Author(s):  
Jörg Klekamp
Keyword(s):  
Structural Changes ◽  
Long Term Results ◽  
Type I ◽  
Type Ii ◽  
New Classification ◽  
Type Iii ◽  
Dural Sac ◽  
Spinal Cord Herniation ◽  
Dural Defects

Abstract BACKGROUND: The clinical significance of pathologies of the spinal dura is often unclear and their management controversial. OBJECTIVE: To classify spinal dural pathologies analogous to vascular aneurysms, present their symptoms and surgical results. METHODS: Among 1519 patients with spinal space-occupying lesions, 66 patients demonstrated dural pathologies. Neuroradiological and surgical features were reviewed and clinical data analyzed. RESULTS: Saccular dural diverticula (type I, n = 28) caused by defects of both dural layers, dissections between dural layers (type II, n = 29) due to defects of the inner layer, and dural ectasias (type III, n = 9) related to structural changes of the dura were distinguished. For all types, symptoms consisted of local pain followed by signs of radiculopathy or myelopathy, while one patient with dural ectasia presented a low-pressure syndrome and 10 patients with dural dissections additional spinal cord herniation. Type I and type II pathologies required occlusion of their dural defects via extradural (type I) or intradural (type II) approaches. For type III pathologies of the dural sac no surgery was recommended. Favorable results were obtained in all 14 patients with type I and 13 of 15 patients with type II pathologies undergoing surgery. CONCLUSION: The majority of dural pathologies involving root sleeves remain asymptomatic, while those of the dural sac commonly lead to pain and neurological symptoms. Type I and type II pathologies were treated with good long-term results occluding their dural defects, while ectasias of the dural sac (type III) were managed conservatively.

scholarly journals Alterations of the thyroid structure and function in experimental hypopinealism

2011 ◽  
Vol 57 (2) ◽  
pp. 32-35
Author(s):  
L A Bondarenko ◽  
L Iu Sergienko ◽  
N N Sotnik ◽  
A N Cherevko
Keyword(s):  
Thyroid Gland ◽  
Structural Changes ◽  
Structure And Function ◽  
Initial Increase ◽  
Histological Structure ◽  
Pituitary Thyroid Axis ◽  
Thyroid Axis ◽  
And Function ◽  
Sexually Mature

The pituitary-thyroid axis of young sexually mature rabbits kept under a 24-hour daylight photoperiod was shown to undergo phase-modulated variations of hormonal activity with its initial increase (during the first month) and subsequent progressive decrease (within 2-5 months after the onset of exposure to light). These changes correlated with the time-dependent fall in the blood T3, T4, and TSH levels. Simultaneously, the animals developed pathological changes in the histological structure of the thyroid gland similar to those in patients with secondary or tertiary hypothyroidism. It is concluded that hormonal and structural changes in the thyroid gland during long-term hypopinealism should be regarded as an experimental model of hypothyroidism of neuroendocrine origin.

scholarly journals PRIMARY-MULTIPLE TUMORS IN PATIENTS WITH NEOPLASMS OF THYROID GLAND

2015 ◽  
Vol 174 (2) ◽  
pp. 70-76
Author(s):  
A. F. Romanchishen ◽  
K. V. Vabalaite
Keyword(s):  
Surgical Treatment ◽  
Thyroid Gland ◽  
Thyroid Carcinoma ◽  
Chemical Nature ◽  
Malignant Tumors ◽  
Long Term Results ◽  
Occupational Hazard ◽  
Other Neoplasms

The authors studied the long-term results of surgical treatment of 949 patients with thyroid carcinoma. The malignant tumors of other organs were revealed in 55 (5,8%) cases during 20 years of follow-up. It was stated that patients with thyroid carcinoma had a higher risk of developing other malignant tumors than in population. A typical background for onset of other neoplasms was a latent hypothyroidism, hyperlipidemia, hypersecretion of gonadotropins, an influence of occupational hazard of chemical nature and hereditary load of oncology.

scholarly journals Autoimmune thyroiditis after long term gonadotropin- releasing hormone agonist treatment for central precocious puberty: case report

2020 ◽  
Vol 12 (1) ◽  
pp. 62-65
Author(s):  
Maja Tankoska ◽  
Avdi Murtezani ◽  
Konstandina Kuzevska-Maneva ◽  
Marina Krstevska – Konstantinova
Keyword(s):  
Thyroid Gland ◽  
Thyroid Function ◽  
Precocious Puberty ◽  
Autoimmune Thyroiditis ◽  
Central Precocious Puberty ◽  
Gonadotropin Releasing Hormone ◽  
Thyroid Antibodies ◽  
Releasing Hormone ◽  
Gonadotropin Releasing Hormone Agonist

There is a small number of studies that have reported abnormalities in endocrine function after a long-term gonadotropin-releasing hormone agonist (GnRHa) treatment in girls. This treatment is considered as safe and effective by most authors. We report our second case of unusual outcome of long-term GnRHa therapy in a girl with central precocious puberty (CPP) of idiopathic or familial etiology. She has received monthly depot of injections of triptorelin for a time period of 4 years. We have examined thyroid function by measuring serum levels of thyrotropin (TSH), thyroxine (T4), thyroid antibodies and ultrasound of thyroid gland. At the age of 11 years she developed a mild goiter and presented with autoimmune thyroiditis, having elevated thyroid antibodies and ultrasound of thyroid gland typical for Hashimoto thyroiditis. Having in mind these two cases, we suggest a closer monitoring of thyroid function in girls with CPP, before and during therapy with GnRH agonist.

scholarly journals THE NEAREST AND LONG-TERM RESULTS OF SURGICAL TREATMENT OF FOCAL PATHOLOGY OF THE THYROID GLAND

2020 ◽  
Vol 73 (1) ◽  
pp. 106-110
Author(s):  
Z.M. Sigal ◽  
◽  
, O.V. Surnina ◽  
V.V. Bryndin ◽  
O.A. Sigal ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Thyroid Gland ◽  
Long Term Results
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